Disaster preparedness training: Who should it reach and how?

The response by the health sector of a disaster-affected country
is a revealing indicator of just how much emphasis has been placed on
strengthening national institutions and training local health personnel. For the
development of human resources - and not the stockpiling of equipment and
material - is the key to sound disaster management.

School children and their teachers
have become receptive target groups of disaster preparedness training. In Costa
Rica, the Ministry of Education has embarked on a successful program aimed at
primary school children. In Pinar del Río, Cuba, children are taught first aid
skills through role playing. (Photo: Carlos Gaggero/PAHO)

Target Groups

Keeping in mind the vulnerability of each country, who needs to be
trained? Perhaps we can approach this question from another angle. Who provides
essential health assistance during and immediately following disaster
situations? The list is lengthy, considering that the health response to
disasters mobilizes all disciplines and depends, to a certain extent, on
decisions made by other key sectors. In the Americas, the audience has broadened
to include the following groups:

· special non-health responders play a decisive role
in emergencies. No component of this group holds more power than the mass media.
Exposing the media to the most commonly-held myths prior to disasters will
prevent the dissemination of misinformation regarding health problems after
disasters. It will also reduce pressure on decision makers to commit resources
to ineffective but highly-visible campaigns. Other key groups include fire and
police departments and the armed forces;

·Ministries of Foreign Affairs represent a vital
link with the outside world. Too often, requests for medical or other health
relief are made by or accepted at the diplomatic level without giving due
consideration to technical or scientific criteria. A better understanding of
health issues in diplomatic missions can only facilitate the effectiveness of
international health relief;

·local communities have the first and last word in
the response to emergencies - the first word because outside assistance,
especially at the international level, always arrives too late; the last word
because most often the affected community is quickly left on its own once the
acute emergency phase has passed. Training communities is essential but
challenging;

·school children and their teachers are extremely
receptive to simple health preparedness education and training. Working together
with Ministries of Education, this strategy has proven to be an effective,
durable means of influencing public opinion concerning emergency health
matters.

Strategies

Disaster preparedness training should be based on the following
policies and strategies:

·training of trainers - not all
organizations nor all training programs can reach the grassroots level, but
preparing a national cadre of experienced trainers is a positive first step.
This is an ongoing process, given the variety of disciplines that disaster
preparedness encompasses and the ever-expanding scope of issues it addresses.
Training of trainers will also ensure the multiplier effect of training;

·courses, workshops, simulation exercises, and
drills, all help to create a critical mass of disaster-literate and influential
health professionals. But there comes a time when this effort cannot be
completely sustained by the international community and disaster preparedness
must be institutionalized nationally for long-term survival. One way in which
countries can accomplish this is to promote the inclusion of disaster
preparedness in the curriculum of schools of medicine, nursing, and engineering;

· once a mechanism has been established to broadly transmit
general skills, efforts can be concentrated on developing new areas of
technical expertise. Because the field of disaster preparedness is ever
expanding, training programs and materials must also be dynamic and up-to-date;

· developing training and educational material and making it
available at no cost to qualified institutions and individuals is indispensable
if the multiplier effect of training is to be successful. These materials
support teaching institutions, Ministries of Health, and NGOs in their role as
trainers.